Experts stress prevention with rise in whooping cough

Doctors say those in contact with children, especially newborns, should get a booster shot

January 19, 2011|By Terri Yablonsky Stat, Special to the Tribune

Jolee Kuehl, 8 months, spent 40 days in the University of Chicago Medical Center with whooping cough because her mother, Crista, had been misdiagnosed with bronchitis, Crista Kuehl said. (Gregg Gearhart, Photo for the Chicago Tribune)

Newborn Jolee Kuehl spent 40 days at the University of Chicago Medical Center, 14 of them on a ventilator, after catching whooping cough from her mother at just 15 days old.

"I was misdiagnosed with bronchitis after Jolee's birth," said Crista Kuehl, 28, who saw several doctors in Valparaiso, where she lives with her husband, Mick; Jolee; and an older daughter, Annika.

Whooping cough, a highly contagious respiratory infection marked by violent coughing, has made a comeback in Chicago and in other parts of the country. Health officials are urging adolescents and adults — especially those who interact with newborns — to get a whooping cough booster shot.

"We're seeing more whooping cough than we used to," said Dr. Kenneth Alexander, head of pediatric infectious diseases at the University of Chicago. That's partly because we live in a global world, Alexander said, but improved diagnostic tests allow health care providers to recognize it more.

In 2010, Chicago had 95 confirmed cases of whooping cough, also known as pertussis, up from 49 in 2009, according to the Chicago Department of Public Health.

When a person with whooping cough tries to breathe between fits of coughs, a characteristic "whooping" sound is often heard. Infants, however, may not have a severe cough; instead they may choke and periodically stop breathing, said Alexander.

Though many adults were immunized as children, immunity wanes after about five to 10 years. In adults who cough longer than two weeks, 15 percent to 20 percent have whooping cough, Alexander said. A suspected case should be treated with antibiotics, which he said won't shorten the duration of the cough, but will help keep the patient from being infectious.

The Chicago Department of Public Health recommends that adults and children ages 11 to 12 get a whooping cough booster shot, called Tdap, that replaces the regular tetanus booster shot given every 10 years. Tdap immunizes against tetanus, diphtheria and pertussis. The Health Department also has used federal funds from the American Recovery and Reinvestment Act to purchase 14,070 doses of Tdap vaccine and distributed them to 13 birthing hospitals to immunize postpartum women before they are discharged.

Vaccinating those around newborns, such as grandparents and caregivers, also is critical. "We refer to it as cocoon immunization," said Alexander. "Since babies don't respond well to the vaccine and are vulnerable for the first four months of life, let's vaccinate everybody in contact with them.

Alexander said immunizing schoolchildren reduces the chance other children will get whooping cough. "Estimates are that if a kid in a class is unvaccinated, the risk of pertussis for all the kids in the class goes up thirtyfold," he said.

At the U. of C., officials are creating a webcast to educate nurses at some private schools in Chicago about the epidemiology, signs and symptoms of pertussis. The webcast also will empower the nurses as they promote the immunization of students and teachers.

The Kuehls, both schoolteachers, called everyone they knew who had been around Jolee to tell them to get treated and revaccinated. They are thankful Jolee has fully recovered.

"The scariest part is when Jolee would stop breathing and turn blue. There wasn't any whooping sound," said Crista Kuehl. "Whooping cough is lethal. If it wasn't for the staff at the University of Chicago, Jolee could have died."